Promoting psychological safety in simulation using a novel visual tool: A mixed-methods quasi-experimental study

Area of Science:

• Healthcare Education
• Nursing Education
• Simulation-Based Learning

Background:

• Psychological safety is crucial for effective healthcare simulation-based learning but difficult to establish.
• A visual tool, Simulation Tool to Enhance Psychological Safety (STEPS), was used with prelicensure nursing students.
• STEPS aimed to support and strengthen psychological safety during simulation activities.

Purpose of the Study:

• To determine the impact of the STEPS tool on psychological safety.
• To assess psychological safety in prelicensure nursing students during simulated learning.

Main Methods:

• Quasi-experimental, one-group pretest-posttest design with mixed-methods approach.
• STEPS implemented in 12 simulation activities over a semester.
• Psychological Safety in High Fidelity Simulation Scale used for pretest-posttest surveys; qualitative data from open-ended responses and focus groups.

Main Results:

• 51 prelicensure nursing students participated.
• Students reported improved perceptions of psychological safety after the STEPS intervention.
• Qualitative data indicated STEPS enhanced learning from mistakes, support, comfort, and confidence.

Conclusions:

• STEPS promotes a safe and supportive learning environment by visually reminding students and faculty.
• The tool helps students reframe mistakes as learning opportunities.
• STEPS can be part of a broader strategy to enhance psychological safety; further research with larger samples is recommended.